Document Detail

Comparison of the accuracy of disk diffusion zone diameters obtained by manual zone measurements to that by automated zone measurements to determine antimicrobial susceptibility.
MedLine Citation:
PMID:  18585805     Owner:  NLM     Status:  MEDLINE    
Although a variety of techniques are available for antimicrobial susceptibility testing, disk diffusion methods remain the most widely used. We compared the accuracy of disk diffusion zone diameters as obtained by manual zone measurements in a low resource country (Indonesia) to that by automated zone measurements (Oxoid aura image system) in a high resource setting (the Netherlands) to determine susceptibility categories (sensitive, intermediate susceptible or resistant). A total of 683 isolates were studied, including 294 Staphylococcus aureus, 195 Escherichia coli and 194 other Enterobacteriaceae. Antimicrobial agents included tetracycline, oxacillin, gentamicin, erythromycin, trimethoprim/sulfamethoxazole and chloramphenicol for S. aureus and ampicillin, gentamicin, cefotaxime, ciprofloxacin, trimethoprim/sulfamethoxazole, and chloramphenicol for E. coli and other Enterobacteriaceae. Of the 4098 drug-organism combinations, overall category agreement (CA), major discrepancy (MD) and minor discrepancy (mD) between the two methods were 82.4% (3379/4098), 6.0% (244/4098) and 11.6% (475/4098), respectively. One hundred and sixty three of 244 MDs were resolved using reference broth microdilution method. Overall very major error (VME), major error (ME) and minor error (mE) of manual zone measurement were 28.8%, 45.4% and 4.9%, respectively and for the aura image system 4.9%, 16.0% and 4.9%, respectively. The results of this study indicate that the disk diffusion method with manual zone measurement in Indonesia is reliable for susceptibility testing. The use of an automated zone reader, such as the aura image system, will reduce the number of errors, and thus improve the accuracy of susceptibility test results for medically relevant bacteria.
Endang Sri Lestari; Juliëtte A Severin; P Margreet G Filius; Kuntaman Kuntaman; D Offra Duerink; Usman Hadi; Hendro Wahjono; Henri A Verbrugh;
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-06-27
Journal Detail:
Title:  Journal of microbiological methods     Volume:  75     ISSN:  0167-7012     ISO Abbreviation:  J. Microbiol. Methods     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-08     Completed Date:  2008-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306883     Medline TA:  J Microbiol Methods     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  177-81     Citation Subset:  IM    
Department of Clinical Microbiology, Dr. Kariadi Hospital, School of Medicine, Diponegoro University, Semarang, Jl. Dr. Soetomo 16-18 Semarang 50231, Indonesia.
Export Citation:
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MeSH Terms
Anti-Bacterial Agents / pharmacology*
Disk Diffusion Antimicrobial Tests / methods*
Enterobacteriaceae / drug effects*
Image Processing, Computer-Assisted / methods*
Quality Control
Reproducibility of Results
Staphylococcus aureus / drug effects*
Reg. No./Substance:
0/Anti-Bacterial Agents
Widjoseno Gardjito / ; Erni P Kolopaking / ; Karjadi Wirjoatmodjo / ; Djoko Roeshadi / ; Eddy Suwandojo / ; Eddy Rahardjo / ; Ismoedijanto / ; Paul Tahalele / ; Hendromartono / ; Hari Parathon / ; Usman Hadi / ; Nun Zairina / ; Mariyatul Qibtiyah / ; Endang Isbandiati / ; Ariawan Soejoenoes / ; Budi Riyanto / ; Hendro Wahjono / ; Musrichan Adhisaputro / ; Winarto / ; Subakir / ; Bambang Isbandrio / ; Bambang Triwara / ; Johnny Syoeib / ; Endang Sri Lestari / ; Bambang Wibowo / ; Muchils A U Sofro / ; Helmia Farida / ; Haspari / ; Tri Laksana Nugraha / ; Peterhans van den Broek / ; Offra Duerink / ; Henri A Verbrugh / ; Inge C Gyssens / ; Monique Keuter /

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